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Severity of periodontal disease and number of remaining teeth are related to the prevalence of myocardial infarction and hypertension in a study based on 4,254 subjects
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
2006 (English)In: Journal of Periodontology, ISSN 0022-3492, Vol. 77, no 7, 1173-1178 p.Article in journal (Refereed) Published
Abstract [en]

Background: During the past 15 years, mounting evidence for the association between periodontal and cardiovascular disease has been presented in epidemiological studies. The aim of this study was to investigate how the severity of periodontal disease and number of remaining teeth relates to myocardial infarction (MI) and hypertension (HT).

Methods: Self-reported history of HT and MI was collected in 3,352 patients referred to the Department of Periodontology, Gavle County Hospital, and in 902 subjects randomly selected from the general population. Severity of periodontitis was estimated by a combination of the amount of bone loss around each tooth investigated from a full-mouth x-ray, the presence or absence of bleeding on probing (BOP), and involvement of furcations.

Results: The severity of periodontitis was significantly associated with HT (prevalence 16%; P < 0.0005), even after adjustment for age, gender, number of teeth, and smoking in the total sample, and with MI (prevalence 1.7%, P < 0.03) after above-mentioned adjustments, but in middle-aged (40 to 60 years) subjects only. The number of diseased periodontal pockets was related to HT only (P < 0.0001), and this relationship remained after the above-mentioned adjustments. The number of teeth was associated with MI (P < 0.03) even after correction for age, gender, and smoking but was not related to hypertension.

Conclusions: The severity of periodontal disease was related to HT independent of age but to the prevalence of MI in middle-aged subjects only. The number of diseased pockets was significantly related to HT only. On the other hand, the number of teeth was associated with the prevalence of MI independent of age but not to HT. These data support the view that oral health is related to cardiovascular disease in a dose-dependent manner.

Place, publisher, year, edition, pages
2006. Vol. 77, no 7, 1173-1178 p.
Keyword [en]
cardiovascular disease, hypertension, inflammation, myocardial infarction, periodontitis
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-97155DOI: 10.1902/jop.2006.050233ISI: 000241879200010PubMedID: 16805679OAI: oai:DiVA.org:uu-97155DiVA: diva2:171971
Available from: 2008-04-28 Created: 2008-04-28 Last updated: 2011-05-12Bibliographically approved
In thesis
1. Oral health and cardiovascular disease
Open this publication in new window or tab >>Oral health and cardiovascular disease
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the past two decades studies have indicated that oral health might be associated with the prevalence for cardiovascular disease (CVD), although the biological link still remains unknown. Bacteria and inflammatory mediators causing periodontal disease have also been suggested to influence the progression of atherosclerosis.

The aims of this thesis were to study oral inflammation and associations between different oral health parameters and CVD.

Inflammatory mediators such as interleukin-1 (IL-1) as well as bone resorption activity (BRA) were significantly higher in gingival crevicular fluid (GCF) from sites with periodontal disease compared to healthy sites. Treatment resulted in a reduction of BRA as well as the levels of IL-1 for most of the diseased pockets. The levels of IL-1 were not correlated to the amount of BRA.

Number of teeth (NT) was consistently associated to CVD and was the only oral health parameter that related to all-cause mortality and mortality in CVD in a dose-dependent manner. Subjects with <10 teeth had a 7-fold increase risk for mortality in coronary heart disease compared to those with >25 teeth. Furthermore, NT was also significantly associated to the levels of leukocytes and to the metabolic syndrome, which consists of a combination of cardiovascular risk factors.

Other investigated oral health parameters, such as severity of periodontal disease, number of deepened pockets, and bleeding on probing, were not related to CVD in a consistent way.

Oral health parameters as well as myocardial infarction (MI) were related to serum antibody levels against Porphyromonas gingivalis (Pg), indicating that Pg might be a link between oral health and MI.

In conclusion, treatment reduced the increased levels of IL-1 and BRA in GCF from sites with periodontal disease. Oral health was associated to CVD with number of teeth being the only oral health parameter that consistently was associated to CVD. Serum antibody levels against P. gingivalis were related to myocardial infarction (MI) as well as to oral health parameters, suggesting that this bacteria could be a link between oral health and CVD.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 93 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 346
Medicine, Oral health, periodontal disease, number of teeth, cardiovascular disease, mortality, Medicin
urn:nbn:se:uu:diva-8708 (URN)978-91-554-7188-0 (ISBN)
Public defence
2008-05-23, Enghoffsalen, Kardiologhuset ingång 50, Akademiska sjukhuset, Uppsala, 09:15
Available from: 2008-04-28 Created: 2008-04-28Bibliographically approved

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